La relación enfermera - padres - neonato desde la perspectiva enfermera / The Relationship Nurse-Parents-Newborn from the Nurse Perspective

RESUMEN Introducción: El nacimiento de un niño supone sentimientos de alegría e ilusión. Esta situación se quiebra cuando requiere su ingreso en una Unidad de Neonatología, lo que provoca en los padres tristeza, miedo o culpabilidad. Sienten necesidad de apoyo y, al convertirse en sujetos activos del cuidado de su hijo, disminuye su grado de ansiedad y mejora su satisfacción. La familia constituye el núcleo de desarrollo del recién nacido; y por ello tiene relevancia el papel de la enfermera en la promoción del vínculo familiar. Objetivo: Explorar la relación enfermera - padres - neonato desde la perspectiva enfermera en la Unidad de Neonatología. Métodos: Estudio cualitativo cuyo marco teórico es el Interaccionismo Simbólico. La población objeto de estudio estuvo constituida por profesionales de enfermería de la Unidad de Neonatología del Hospital Universitario La Paz. Los datos se recogieron mediante entrevistas en profundidad y se analizaron bajo Teoría Fundamentada como marco metodológico. Resultados: Se realizaron seis entrevistas y se alcanzó saturación de los datos. Se generaron 20 categorías y 12 subcategorías. Las participantes identificaron elementos que afectan a las interacciones entre la enfermera, los padres y el recién nacido, así como necesidad de individualizar los cuidados durante una evolución no lineal del neonato. Conclusiones: La figura de la enfermera resulta fundamental en el cuidado del recién nacido y de sus padres, de modo que la relación enfermera - padres - neonato resulta compleja, dinámica y única(AU)

ABSTRACT Introduction: A child birth is expected to bring feeling joy and illusion. This situation gets destroyed when the newborn requires admittance into a neonatal care unit, which causes the parents to feel sadness, fear and culpability. They feel the need for support and, by becoming active subjects in their child's care, their anxiety level decreases and their satisfaction improves. The family constitutes the nucleus of development for the newborn. Hence, the importance of nurse role in fostering family ties. Objective: To explore relationship nurse-parents-neonate from the perspective of the neonatal care unit nurse. Methods: Qualitative study whose theoretical framework is symbolic interactionism. The study population was made up by nursing professionals of the neonatal care unit of La Paz University Hospital. Data were collected through in-depth interviews and analyzed using grounded theory as methodological framework. Results: Six interviews were carried out and data saturation was achieved. Twenty categories and 12 subcategories were generated. The participants identified elements affecting the interactions between nurse, parents and newborn, as well as the need for individualizing care during the newborn non-linear evolution. Conclusions: The figure of the nurse is fundamental in the care of the newborn and the parents, which determines that the relationship nurse-parents-neonate is complex, dynamic and unique(AU)

Loss of nuclear NOTCH1, but not its negative regulator NUMB, is an independent predictor of cervical malignancy.

The participation of NOTCH signaling in invasive cervical cancer (ICC) remains controversial since both tumor suppressive and oncogenic properties have been described. Additionally, the role of NUMB, a negative regulator of NOTCH, remains unclear in ICC. We aimed to investigate the role of NOTCH1 and NUMB expression and their localization in cervical intraepithelial neoplasia (CIN) and ICC samples. A total of 144 biopsies were obtained from the Instituto Nacional de Cancerología, México from 2004 to 2017, and were subjected to immunohistochemistry for NOTCH1 and NUMB. We found that nuclear NOTCH1 expression was more frequently found in CIN samples compared with ICC (77.55% vs. 15.79%, p = 0.001). NUMB was almost exclusively found in the nucleus of CIN samples (32.65% vs. 6.32%, p = 0.001). Cytoplasmic expression of NOTCH1 (44.21%) and NUMB (35.79%) was the most frequent localization in ICC. Multivariable-adjusted analysis showed that the loss of nuclear NOTCH1 expression was an independent predictor of malignancy (ß = -3.428, 95% confidence interval [95% CI] = -5.127, -1.728, p = 0.001). In contrast, the association between cytoplasmic NUMB expression and cervical cancer was lost after adjusting for nuclear NOTCH1 expression (ß = 2.074, 95% [CI] = -0.358, 4.506, P = 0.094). Additionally, patients with cytoplasmic NOTCH1 expression showed a borderline association with longer overall survival (OS) than those with nuclear NOTCH1 expression (P = 0.08). Our data suggest that the loss of nuclear NOTCH1 but not NUMB might be an independent predictor of malignancy in cervical cancer.